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Fatal Meningitis Following Reduction Malarplasty: A Previously Unreported Complication

Jee Hyun Moon1,2, Gun Hee Lee1

  • 1Department of Plastic and Reconstructive Surgery, Inha University Hospital.

The Journal of Craniofacial Surgery
|June 1, 2026
PubMed

Insights

Reduction malarplasty can rarely lead to fatal intracranial infections, such as meningitis. Careful surgical planning and early recognition of neurological symptoms are vital to prevent and manage this rare but serious complication.

Area of Science:

  • Plastic Surgery
  • Neurosurgery
  • Infectious Diseases

Background:

  • Reduction malarplasty is a cosmetic surgical procedure to reduce cheekbone prominence.
  • Major complications are uncommon and typically not life-threatening.
  • Intracranial infectious complications following this procedure have not been previously reported.

Purpose of the Study:

  • To report a fatal case of postoperative meningitis after reduction malarplasty.
  • To highlight the potential risk of intracranial infection associated with this procedure.
  • To emphasize the importance of surgical precision and early diagnosis.

Main Methods:

  • Case report of a 35-year-old female patient presenting with altered mental status.
  • Review of clinical presentation, imaging (craniofacial), and laboratory findings.
  • Analysis of potential surgical factors contributing to the complication.

Main Results:

  • The patient developed bacterial meningitis with intracranial involvement approximately two weeks post-revisional reduction malarplasty.
  • Imaging suggested possible dural violation by fixation hardware, potentially creating a route for infection.
  • The complication was fatal, underscoring the severity of intracranial infections.

Conclusions:

  • Reduction malarplasty, while generally safe, carries a rare risk of fatal intracranial infections.
  • Meticulous surgical planning and accurate fixation are critical to avoid dural penetration.
  • Prompt recognition and management of neurological symptoms are essential for improved patient outcomes.
Keywords:
Case reportscosmetic surgeryfacial bonesmeningitis

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